Provider Demographics
NPI:1265071583
Name:OIW MEDICAL CENTER INC
Entity type:Organization
Organization Name:OIW MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:SINCLAIR
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-593-4357
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-1043
Mailing Address - Country:US
Mailing Address - Phone:770-593-4357
Mailing Address - Fax:770-808-6788
Practice Address - Street 1:6148 COVINGTON HWY STE A
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-8372
Practice Address - Country:US
Practice Address - Phone:770-593-4357
Practice Address - Fax:770-808-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty